Nagy Stephanie, Tehrani Lily, Kesselman Marc M
Rheumatology, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA.
Cureus. 2025 Apr 24;17(4):e82899. doi: 10.7759/cureus.82899. eCollection 2025 Apr.
Scleroderma is an autoimmune disease characterized by thickened and hardened skin, Raynaud's phenomenon, calcinosis, telangiectasias, joint and muscle problems, as well as respiratory, cardiac, renal, and gastrointestinal disturbances. Scleroderma can be classified as either localized or systemic. Localized scleroderma refers to sclerosis of isolated areas of the body confined to the skin and subcutaneous layer, but it does not involve the distal extremities. However, an exception to this in some cases is morphea, which may progress to organs. In comparison, systemic scleroderma affects both cutaneous and visceral organs. Diagnosis of the condition is made by clinical presentation, medical history, and diagnostic tests. Current treatment options for scleroderma include cyclophosphamide, methotrexate, azathioprine, mycophenolate mofetil, and hematopoietic stem cell transplant. However, immunosuppressive agents used to treat scleroderma are associated with adverse effects. An unmet need exists for alternative therapies that are tied to a lower risk of adverse events. Ultraviolet (UV)-A1 phototherapy has increasingly been analyzed for use within autoimmune conditions as both a potential first-line or adjuvant treatment option. As such, we conducted a systematic literature review of a total of 293 articles using Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Based on our inclusion and exclusion criteria, we included 11 articles in this review, which consisted of a total of 166 patients, the majority being female at 140 (84.3%) patients and only 26 males (15.7%). Overall, patients who received UV-A1 phototherapy saw beneficial effects, including improvements in skin elasticity, mobility of extremities, reduction of skin thickness within sclerotic areas, ulcer improvement, skin softening, reduction of skin tightness, and reduction in collagen bundle size and thickness. UV-A1 phototherapy has the potential to become an integral component of scleroderma management, offering a non-invasive and effective option for patients.
硬皮病是一种自身免疫性疾病，其特征为皮肤增厚和硬化、雷诺现象、钙质沉着、毛细血管扩张、关节和肌肉问题，以及呼吸、心脏、肾脏和胃肠道紊乱。硬皮病可分为局限性或系统性。局限性硬皮病是指身体孤立部位的硬化，局限于皮肤和皮下层，但不涉及远端肢体。然而，在某些情况下，局限性硬皮病的一个例外是线状硬皮病，它可能会发展到累及器官。相比之下，系统性硬皮病会影响皮肤和内脏器官。该病的诊断依据临床表现、病史和诊断测试。目前硬皮病的治疗选择包括环磷酰胺、甲氨蝶呤、硫唑嘌呤、霉酚酸酯和造血干细胞移植。然而，用于治疗硬皮病的免疫抑制剂会产生不良反应。对于不良事件风险较低的替代疗法存在未满足的需求。紫外线（UV）-A1光疗越来越多地被分析用于自身免疫性疾病，作为一种潜在的一线或辅助治疗选择。因此，我们使用Ovid、科学网和护理及相关健康文献累积索引（CINAHL）对总共293篇文章进行了系统的文献综述。根据我们的纳入和排除标准，我们在本综述中纳入了11篇文章，共166例患者，其中大多数为女性，有140例（84.3%），男性仅26例（15.7%）。总体而言，接受UV-A1光疗的患者出现了有益效果，包括皮肤弹性改善、肢体活动度提高、硬化区域皮肤厚度减小、溃疡改善、皮肤软化、皮肤紧绷感减轻以及胶原束大小和厚度减小。UV-A1光疗有可能成为硬皮病治疗的一个重要组成部分，为患者提供一种非侵入性的有效选择。
